Zolpidem tissue concentrations in a multiple drug related death involving Ambien.

Zolpidem (Ambien), a relatively new nonbenzodiazepine sedative-hypnotic, was involved in the death of a 39-year-old obese male who was being treated for depression and insomnia. The identification and quantitation procedures of zolpidem in postmortem tissues included dual-column gas chromatography (GC) with nitrogen-phosphorus detection and GC-mass spectrometry. Zolpidem was present at concentrations of 2.91, 1.40, and 2.13 microg/mL in the heart blood, peripheral blood, and urine, respectively. The liver had zolpidem present at a concentration of 4.74 microg/g, and the gastric contents had a total of 172 mg zolpidem. Additional drugs present included hydrocodone and morphine (nonconjugated) at 0.16 and 0.04 microg/mL, respectively. The cause of death was determined to be multiple drug intoxication. This report describes the analytical techniques and significance of the zolpidem findings.

Partial pressures of oxygen and carbon dioxide, pH, and concentrations of bicarbonate, lactate, and glucose in pleural fluid from horses.

Samples of pleural fluid from 20 horses with effusive pleural diseases of various causes were evaluated; samples from 19 horses were used for the study. There were differences for pH (P = 0.001) and partial pressure of oxygen (PO2) between arterial blood and nonseptic pleural fluid (P = 0.0491), but there were no differences for pH, PO2, partial pressure of carbon dioxide (PCO2), and concentrations of bicarbonate (HCO3-), lactate, and glucose between venous blood and nonseptic pleural fluid. Paired comparisons of venous blood and nonseptic pleural fluid from the same horse indicated no differences. There were differences (P = 0.0001, each) for pH, PO2, PCO2, and concentrations of HCO3- between arterial blood and septic pleural fluid. Differences also existed for pH (P = 0.0001), PCO2 (P = 0.0003), and concentrations of HCO3- (P = 0.0001), lactate (P = 0.0051), and glucose (P = 0.0001) between venous blood and septic pleural fluid. Difference was not found for values of PO2 between venous blood and septic pleural fluid, although 4 samples of septic pleural fluid contained virtually no oxygen. Paired comparisons of venous blood and septic pleural fluid from the same horse revealed differences (P less than 0.05) for all values, except those for PO2. These alterations suggested functional and physical compartmentalization that separated septic and healthy tissue. Compartmentalization and microenvironmental factors at the site of infection should be considered when developing therapeutic strategies for horses with septic pleural disease.

Laboratory reference values for a group of captive Ball Pythons (Python regius)

OBJECTIVE: Laboratory reference values, including hematologic and serum biochemical variables, and oropharyngeal bacteria flora, were determined in a group of captive Ball Pythons (Python regius). ANIMALS: 20 adult Ball Pythons, weighing between 700 and 1,510 g, were allowed to acclimate at the recommended temperature range for the species (25 C night-time, up to 30 C daytime), then were evaluated for internal parasites and treated with appropriate medication prior to the start of the study. PROCEDURE: Hematologic values determined included WBC, hemoglobin, hematocrit, plasma protein, and differential cell count. Clinical biochemical analysis included determination of glucose, uric acid, calcium, phosphorus, total protein, alanine transaminase, alkaline phosphatase, and aspartate transaminase values. In addition to blood values, oropharyngeal swab specimens of the mouth were submitted for culture to determine the species of bacteria found in this population. Descriptive statistics were calculated for each hematologic and clinical biochemical value. Mean, SEM, and ranges were calculated. RESULTS: Hematologic values were similar to those reported in other snake species, except the hematocrit, which was lower. Clinical biochemical values different from those of other species were alkaline phosphatase activity, which was lower, and calcium and phosphorus concentrations, which were lower than values in other species. Bacteria isolated from the oropharynx were principally gram-negative organisms. CONCLUSION: Reference intervals reported in this study are important for establishing a database for comparative studies of Ball Pythons in other locations and under different husbandry conditions. CLINICAL RELEVANCE: Accumulated laboratory reference values will assist veterinarians in assessing the health status of Ball Pythons.

Effects of single-dose L-asparaginase on coagulation values in healthy dogs and dogs with lymphoma.

Ten healthy dogs and 10 dogs with multicentric lymphoma were given a single dose of L-asparaginase at a rate of 10,000 IU/m2 of body surface. Assessment of concentrations of contributors to the coagulation process and of the ability to coagulate including antithrombin III, one-stage prothrombin time, prothrombin-proconvertin time, activated partial thromboplastin time, plasminogen, fibrinogen, and platelet number were performed prior to drug administration (day 0). These tests were repeated 24 hours (day 1), 48 hours (day 2), and 7 days after treatment with L-asparaginase. Antithrombin-III concentrations were significantly lower in the dogs with lymphoma than in healthy dogs on days 0, 1, 2, and 7; however, with the exception of day 1, mean values remained within normal limits. There was also a difference between the 2 groups in prothrombin/proconvertin values on day 7 and in platelet number on day 2, with the lymphoma group having significantly shorter prothrombin/proconvertin time than healthy dogs, and the difference in platelet numbers being associated with increased counts in the healthy dogs. Data obtained from the healthy dogs and dogs with lymphoma for each coagulation test were pooled for each treatment day (0, 1, 2, and 7), and day-0 values for each coagulation test were compared with data obtained on days 1, 2, and 7. Antithrombin-III concentration on day 7 was significantly lower than on day 0, prothrombin/proconvertin time on day 1 was significantly longer than on day 0, and fibrinogen concentrations on days 1 and 2 were significantly lower than on day 0.(ABSTRACT TRUNCATED AT 250 WORDS)

Suitability of shredded tires for use in landfill leachate collection systems.

The suitability of shredded tires or "tire chips" for use in the leachate collection drainage layer of a municipal solid waste landfill was investigated in terms of the: (1) compressibility of the tire chips and resulting changes in hydraulic conductivity under varying applied loads, and (2) effect of leachate pH on the shredded tries compressibility and hydraulic conductivity behavior. A constant head hydraulic conductivity apparatus was fabricated to measure the hydraulic conductivity of the tire shred sample under different axial strains. Further, the fabricated assembly was capable of measuring hydraulic conductivity of the sample at various sample locations at a given strain level. One aim of this study was to provide supporting information for permission to use tire chips as an alternative to crushed stone in the leachate collection system of a landfill. Shredded tires from two different sources were used in this study to investigate any differences in the sensitivity of the shredding process to compressibility and hydraulic conductivity responses under varied applied loads. Under applied vertical loads resulting in average vertical stresses of up to 440 kPa, equivalent to over 50 m of waste, the maximum normal strain recorded in each type of tire chip was observed to plateau at a strain level near or slightly greater than 0.5. The results of the permeability testing indicated average hydraulic conductivity values ranging between 0.67 and 13.4 cm/s under average applied normal stresses ranging from approximately 60 to 335 kPa and strain increments between 0.3 and 0.5. These results are one to three orders of magnitude higher than the hydraulic conductivity typically specified for drainage layers in leachate collection systems of 0.01 cm/s. Additional tests were also carried out to identify how landfill leachate and varied pH levels may affect the compressibility and hydraulic conductivity of the shredded tires. Care should be exercised in extending these results to field conditions, as the results presented are based on limited experimental testing data and a limited time frame.

Fatal food-induced anaphylaxis.

Fatal food-induced anaphylaxis is rarely reported. In 16 months, we identified seven such cases involving five males and two females, aged 11 to 43 years. All victims were atopic with multiple prior anaphylactic episodes after ingestion of the incriminated food (peanut, four; pecan, one; crab, one; fish, one). In six cases the allergenic food was ingested away from home. Factors contributing to the severity of individual reactions included denial of symptoms, concomitant intake of alcohol, reliance on oral antihistamines alone to treat symptoms, and adrenal suppression by chronic glucocorticoid therapy for coexisting asthma. In no case was epinephrine administered immediately after onset of symptoms. Premortem or postmortem serum samples were available from six victims; in each case elevated levels of IgE antibodies to the incriminated food were demonstrated. Food-sensitive individuals must self-administer epinephrine promptly at the first sign of systemic reaction. Emergency care providers should be aware of cricothyrotomy as a life-saving procedure.